Characterization and determination of prevalence in autoimmune liver diseases in a tertiary center.

Abstract

Introduction and Objectives

Autoimmune Hepatic Diseases (AHD) involve a chronic immunomediated response towards hepatocytes and bile ducts, as seen in Primary Biliary Cholangitis (PBC), Autoimmune Hepatitis (AIH), and Primary Sclerosing Cholangitis (PSC). Their complex diagnosis, lack of studies, and irreversible liver damage pose significant challenges today due to increased mortality.

Materials and Patients

A retrospective (cross-sectional, retrolective) study was conducted. Patient records from men and women aged 18 and above attending the Liver Clinic from 2020 to 2023 were analyzed. Data included demographic, clinical, biochemical, serological, and histological variables compatible with EHAI diagnosis. Descriptive statistics such as frequency, percentages, measures of central tendency, and dispersion were employed for qualitative and quantitative variables.

Results

The prevalence of AHD during the evaluated period was 11.5% in our population. A total of 201 patients were identified, comprising 85 (42%) with PBC, 65 (32%) with AIH, 7 (4%) with PSC, and 44 (22%) with overlap (Figure 1). Among them, 177 (88%) were female. The mean age at diagnosis was 51 years ± 13.2. 28% had associated autoimmune diseases, with thyroid disease being the most common at 33%. Hepatic cirrhosis was the most frequent presentation (60%) at diagnosis, with 60% exhibiting decompensation (64% with variceal digestive bleeding) (Figure 2). PBC accounted for 47% of cirrhosis cases. Liver transplantation was performed in 6% of EHAI cases, mainly due to AIH.

Conclusions

The diagnosis of AHD shows a progressive increase. A high incidence of advanced stages of liver disease related to AHD is observed. Further research is needed to define the prevalence and characterize these patients, thus enhancing early and effective diagnosis.